Stretches for Achy Hips!

Without rehabilitation, the postnatal body has a non optimal core. From Diastasis Recti to pelvic floor dysfunction, inhibited multifidus/lower back muscles (especially in the lumbar spine), thoracic immobility (tight ribs), and possibly abdominal adhesions from a C-Section incision- there are a multitude of maternal physiological impairments to consider.

The body continues to perform by enlisting non optimal biomechanics to compensate for the lack of core strength. Compensatory strategies help to achieve the stability, strength and endurance that the core is not providing, but exacerbate deteriorating movements in a snowball effect. This is very evident in the pelvis. When the deep stabilizing core is unable to provide adequate pelvic stability control, the smaller muscles that are designed to help the core take on too much of the task. They become stuck, gripped, and can cause referred pain throughout the body.

Knowing to stretch the common overused and vulnerable muscles can not only provide tremendous relief to the postnatal body, but can unveil the underlying weakness and allow us to address it functionally, from the core foundation up.

Piriformis: This muscle originates on the anterior surface of the sacrum and inserts into the greater trochanter of the femur. Visualize a rope from your hip joint across the back pocket of your jeans to your sacrum. An overused hypertonic (tight) piriformis will pull your hip back into the socket- think of shortening that rope. This will pull you out of alignment and further impede core function. This postural effect can also often be seen reflected in the thorax, with a flaring of the contralateral ribs, and some degree of rib displacement.

Psoas: This muscle originates on the spine T12/L5 and is fascially connected to the diaphragm- one of the deep core stabilizing muscles. The psoas inserts into the lesser trochanter of the femur (think hip flexor/groin) and effectively attaches our upper body to our lower body. Poor posture/forward flexion will shorten the psoas, which then exacerbates forward flexion, inhibiting lumbar mobility and putting the lumbar stabilizers (multifidus) to sleep. A tight psoas will also cause a "poochy" belly, as the abdominal contents are pushed down and against the abdominal wall.

Obturator Externus and Internus: These muscles originate on the obturator membrane which is directly connected to the pelvic floor, another of the deep core stabilizers. They both insert into the posteromedial surface of the greater trochanter of the femur (just like the piriformis). A tight obturator externus can radiate pain up to PSIS (the bumpy joint at the top back of your pelvis/iliac crest) and can also radiate like an ache down the back of the leg to the outside of the knee. Hypertonicity in either the obturator internus or externus can cause referred hypertonicity in the pelvic floor which will further impede core strength and can contribute to pelvic floor dysfunction.

Here are some quick and easy releases for bothersome, tired, cramped and achy pelvic muscles:

Piriformis Release:

1. Stand with back against the wall and place a tennis ball “in the back pocket of your jeans”, taking care to not place it on the sacrum.
2. Feel if it is sore or tense- melt over top of the ball with core breaths.
3. When you feel less tender, remove the ball and notice any difference between the 2 sides.
4. Repeat if needed.
5. Perform on other side.

Psoas Release Extension:

• From a lunge position with rear leg laying on the floor, open up the hip and lengthen the thigh bone.
• Place hand of standing leg on knee, then place other hand on same knee
• Lift torso tall in lunge, placing weight in hands
• Raise the hand of the lunging leg above the head
• Twist torso away from standing leg, towards lunge leg
• Return to center and bend away from Psoas/lunge leg

Obturator Externus Stretch:

• Lay on back and cross legs over each other, pressing ankles down towards the floor, away from each other
• Hold for 30 secs
• Switch legs under/over and repeat other side

Seated obturator Externus as an option:

• Sit on your hip and cross top leg over bottom with foot on floor
• Hug knee to chest sitting tall through spine
• Inhale, relax the jaw and breathe into the top hip.

Obturator Internus:

• Lay on your back and place your feet on the floor, knees bent.
• Place soles of the feet together and let knees drop to sides
• Inhale, relax the jaw and breathe into your pelvis.